Fibromyalgia in Pregnancy: Neuro-Endocrine Fluctuations Provide Insight into Pathophysiology and Neuromodulation Treatment 2023,Mucci et al

Abstract:
Fibromyalgia (FM) is a chronic pain disorder with unclear pathophysiological mechanisms, which leads to challenges in patient management. In addition to pain, the disorder presents with a broad range of symptoms, such as sleep disruption, chronic fatigue, brain fog, depression, muscle stiffness, and migraine. FM has a considerable female prevalence, and it has been shown that symptoms are influenced by the menstrual cycle and periods of significant hormonal and immunological changes.

There is increasing evidence that females with FM experience an aggravation of symptoms in pregnancy, particularly during the third trimester and after childbirth. In this perspective paper, we focus on the neuro-endocrine interactions that occur between progesterone, allopregnanolone, and cortisol during pregnancy, and propose that they align with our previously proposed model of FM pathogenesis based on GABAergic “weakening” in a thalamocortical neural loop system.

Based on our hypothesis, we introduce the possibility of utilizing transcranial direct current stimulation (tDCS) as a non-invasive treatment potentially capable of exerting sex-specific effects on FM patients.

https://www.mdpi.com/2227-9059/11/2/615

 

Uh, from what I can see in anecdotal reports, the opposite is far more common, remission during pregnancy. Far more than the opposite. Would have been much smarter to study this without this assumption of one direction, and it's puzzling that they focused on the less common one. Maybe they don't recognize the opposite, they're not seeing the point of recording that patient's overall condition has improved from pregnancy, so it's not found in healthcare records.

The problem with filtered input: you only input what you want to be recorded. It's hard to believe how common the practice of writing something different than what the patient is told, if they're told anything. You can't do real science on filtered data, it's already interpreted and classified in a way that prevents from looking at the real world, only the perception of a few.

 

What an excuse, a worsening of FM symptoms for THREE months, for promoting transcranial direct current stimulation and theory to go with it.

In many general FM studies, the average age is 46. This being a cohort of middle-aged onset which may or may not have anything to do with pre- or peri-menopausal hormone dysregulatlon. I would hope researchers would pick up on that thread.

I am not and never will be qualified to parse their interesting but too complicated theoretical underpinnings.